Supplementary Table S1 Correlation Coefficients Between Childhood Anthropometrics and Total

Supplementary Table S1 Correlation coefficients between childhood anthropometrics and total body and abdominal fat mass measures

Abbreviations: BMI; body mass index; FMP; fat mass percentage; AVGFM; android/gynoid fat mass ratio; SCAFM; subcutaneous area fat mass; PPAFM; preperitoneal area fat mass;

Values represent Pearson correlation coefficients and Spearmen rank correlation coefficients (subcutaneous area fat mass, preperitoneal area fat mass)

** P-value<0.001

Height / Weight / BMI / FMP / AVGFM / SCAFM / PPAFM
Height / 1
Weight / 0.76** / 1
BMI / 0.30** / 0.84** / 1
FMP / 0.19** / 0.58** / 0.70** / 1
AVGFM / 0.13** / 0.48** / 0.61** / 0.65** / 1
SCAFM / 0.21** / 0.51** / 0.61** / 0.82** / 0.56** / 1
PPAFM / 0.22** / 0.40** / 0.42** / 0.56** / 0.39** / 0.65** / 1

Supplementary Table S2 Correlation coefficients between childhood anthropometrics and total body and abdominal fat mass measures with cardiovascular risk factors

SBP / DBP / LVM / Total-cholesterol / LDL- cholesterol / HDL- cholesterol / TG / Insulin / C-Peptide
Height / 0.21** / 0.09** / 0.50** / 0.00 / -0.01 / 0.04* / -0.05* / 0.12** / 0.08**
Weight / 0.29** / 0.15** / 0.52** / 0.07** / 0.05** / 0.00 / -0.01 / 0.15** / 0.13**
BMI / 0.25** / 0.10** / 0.36* / 0.09** / 0.08** / -0.03 † / 0.05* / 0.13** / 0.13**
FMP / 0.21** / 0.14** / 0.08** / 0.15** / 0.17** / -0.07** / 0.08* / 0.09** / 0.11**
AVGFM / 0.15** / 0.07** / 0.15** / 0.10** / 0.10** / -0.09** / 0.14** / 0.08** / 0.12**
SCAFM / 0.19** / 0.11** / 0.10** / 0.13** / 0.15** / -0.03 / 0.06* / 0.09** / 0.05*
PPAFM / 0.14** / 0.07** / 0.03* / 0.15** / 0.13** / 0.02 / 0.07** / 0.09** / 0.06*
SBP / 1 / 0.62** / 0.12** / 0.08** / 0.05* / 0.06 † / -0.01 / 0.07** / 0.04 †
DBP / 1 / 0.02 / 0.05* / 0.05* / 0.04* / -0.02 / -0.02 / -0.05*
LVM / 1 / -0.04* / -0.04* / 0.02 / -0.06* / 0.07** / 0.06*
Total-cholesterol / 1 / 0.86** / 0.29** / 0.16** / -0.02 / -0.04*
LDL-cholesterol / 1 / -0.06* / 0.13** / -0.05* / -0.06*
HDL-cholesterol / 1 / -0.39** / -0.06* / -0.10**
TG / 1 / 0.19** / 0.20**
Insulin / 1 / 0.88**
C-Peptide / 1

Abbreviations: BMI; body mass index; FMP; fat mass percentage; AVGFM; android/gynoid fat mass; SCAFM; subcutaneous fat mass area; PPAFM; preperitoneal fat mass area; SBP; systolic blood pressure; DBP; diastolic blood pressure; LVM; left ventricular mass; LDL-cholesterol; low density lipoprotein cholesterol; HDL-cholesterol; high density lipoprotein cholesterol; TG triglycerides;

Values represent Pearson correlation coefficients and Spearmen rank correlation coefficients (subcutaneous area fat mass, preperitoneal area fat mass, TG, Insulin, C-peptide)

† < 0.05 * P-value<0.01 ** P-value<0.001

Supplementary Table S3 Associations of childhood total body and abdominal fat mass measures with cardiovascular risk factors, adjusted for height and body mass index

Cardiovascular risk factors / General adiposity / Body fat distribution / Abdominal fat mass distribution
N / Body mass index (SDS) / N / Fat mass percentage(SDS) / Android/Gynoid fat mass (SDS) / N / Subcutaneous fat mass area (SDS) / Preperitoneal fat mass area (SDS)
Systolic blood pressure (SDS) / 6069 / 0.22 (0.19, 0.24)** / 5958 / 0.03 (-0.01, 0.07) / 0.02 (-0.02, 0.05) / 5020 / 0.02 (-0.02, 0.06) / -0.00 (-0.04, 0.03)
Diastolic blood pressure (SDS) / 6069 / 0.07 (0.04, 0.09)** / 5958 / 0.09 (0.05, 0.13)* / 0.03 (0.00, 0.06)* / 4971 / 0.04 (0.00, 0.08)* / -0.01 (-0.04, 0.03)
Left ventricular mass (SDS) / 5966 / 0.35 (0.33, 0.37)** / 5825 / -0.25 (-0.29, -0.22)** / -0.07 (-0.10, -0.04)** / 5072 / -0.18 (-0.21, -0.15)** / -0.17 (-0.20, -0.15)*
Total-cholesterol (SDS) / 4321 / 0.08 (0.05,0.11)** / 4140 / 0.14 (0.09, 0.19)** / 0.06 (0.02, 0.10)* / 3445 / 0.12 (0.07, 0.17)** / 0.13 (0.09, 0.17)**
LDL- cholesterol (SDS) / 4216 / 0.08 (0.05, 0.12)** / 4143 / 0.16 (0.11, 0.21)** / 0.07 (0.03, 0.11)** / 3448 / 0.14 (0.09, 0.19)** / 0.11 (0.07, 0.15)**
HDL- cholesterol (SDS) / 4217 / -0.08 (-0.11, -0.05)** / 4144 / -0.06 (-0.11, -0.01)* / -0.10 (-0.14, -0.06)** / 4352 / -0.02 (-0.07, 0.03) / 0.02 (-0.02, 0.07)
Triglycerides (SDS) / 4202 / 0.11 (0.07, 0.14)** / 4130 / 0.07 (0.02, 0.12)† / 0.17 (0.12, 0.21)** / 3438 / 0.06 (0.01, 0.11)† / 0.09 (0.05, 0.14)**
Insulin (SDS) / 4173 / 0.17 (0.14, 0.20)** / 4093 / 0.05 (-0.01, 0.10) / 0.04 (0.00, 0.08) / 3410 / 0.01 (-0.04, 0.06) / 0.04 (-0.00, 0.08)
C-peptide (SDS) / 4182 / 0.14 (0.11, 0.17)** / 4102 / 0.04 (-0.01, 0.09) / 0.06 (0.02, 0.11) / 3419 / -0.02 (-0.06, 0.04) / 0.03 (-0.02, 0.07)

Abbreviations: N; number; SDS; standard deviation scores;

Values are linear regression coefficients (95% confidence interval). Effect estimates represent differences in cardiovascular risk factors per standard deviation scores of childhood total body and abdominal fat mass measures. Models are adjusted for age, sex and ethnicity. Models with body fat and abdominal fat mass measures are additionally adjusted for height and body mass index. † < 0.05 * P-value<0.01 ** P-value<0.001

Cardiovascular risk factors
Systolic blood pressure (SDS) / Diastolic blood pressure (SDS) / Left ventricular mass (SDS) / Total-cholesterol
(SDS) / LDL-cholesterol
(SDS) / HDL-cholesterol
(SDS) / Triglycerides
(SDS) / Insulin
(SDS) / C-peptide
(SDS)
General adiposity / R² / R² / R² / R² / R² / R² / R² / R² / R²
BMI (SDS) / 0.07 / 0.03 / 0.22 / 0.02 / 0.03 / 0.02 / 0.02 / 0.03 / 0.03
Body fat distribution
FMP (SDS)
Model 1 / 0.08 / 0.03 / 0.29 / 0.03 / 0.04 / 0.03 / 0.02 / 0.03 / 0.03
Model 2 / 0.09 / 0.03 / 0.37 / 0.03 / 0.04 / 0.03 / 0.02 / 0.04 / 0.03
AVGFM (SDS)
Model 1 / 0.07 / 0.03 / 0.29 / 0.02 / 0.03 / 0.03 / 0.03 / 0.03 / 0.03
Model 2 / 0.09 / 0.03 / 0.35 / 0.02 / 0.03 / 0.03 / 0.03 / 0.04 / 0.03
Abdominal fat mass distribution
SCAFM (SDS)
Model 1 / 0.08 / 0.03 / 0.29 / 0.03 / 0.03 / 0.02 / 0.02 / 0.03 / 0.02
Model 2 / 0.09 / 0.03 / 0.36 / 0.03 / 0.03 / 0.02 / 0.01 / 0.03 / 0.03
PPAFM (SDS)
Model 1 / 0.07 / 0.03 / 0.29 / 0.03 / 0.03 / 0.02 / 0.02 / 0.03 / 0.02
Model 2 / 0.09 / 0.03 / 0.37 / 0.03 / 0.03 / 0.02 / 0.02 / 0.03 / 0.03

Supplementary Table S4Variance explained by models in the associations of childhood total body and abdominal fat mass measures with cardiovascular risk factors

Abbreviations: SDS; standard deviation scores; R²; variance explained by models; BMI; body mass index; FMP; fat mass percentage; AVGFM; android/gynoid fat mass; SCAFM; subcutaneous fat mass area; PPAFM; preperitoneal fat mass area; Model 1 is adjusted for age, sex, ethnicity and height. Model 2 is adjusted for age, sex, ethnicity, height and body mass index.

Supplementary Table S5 Association of childhood total body and abdominal fat mass measures with c-peptide levels among underweight, normal weight, overweight and obese children

C-peptide (SDS)
Fat mass percentage(SDS)
Underweight / 0.13 (-0.12, 0.38)
Normal weight / 0.03 (-0.02, 0.08)
Overweight / 0.12 (0.01, 0.23)†
Obese / 0.33 (0.14, 0.51)*
P-value for interaction / <0.01
Android/Gynoid (SDS)
Underweight / 0.13 (-0.12, 0.37)
Normal weight / 0.05 (-0.00, 0.10)
Overweight / 0.11 (0.02, 0.19)*
Obese / 0.16 (0.03, 0.29)†
P-value for interaction / <0.01
Subcutaneous area (SDS)
Underweight / -0.02 (-0.22, 0.18)
Normal weight / 0.04 (-0.00, 0.09)†
Overweight / 0.05 (-0.05, 0.15)
Obese / 0.18 (0.02, 0.35)*
P-value for interaction / <0.01
Preperitoneal area (SDS)
Underweight / 0.02 (-0.18, 0.23)
Normal weight / 0.04 (-0.01, 0.08)
Overweight / -0.01 (-0.14, 0.12)
Obese / 0.20 (-0.05, 0.47)
P-value for interaction / <0.01

Abbreviations: SDS;standard deviation scores; Values are linear regression coefficients (95% confidence interval). Effect estimates represent differences in c-peptide levels per SDS change of total body fat mass measures and abdominal fat mass measures among different obesity categories. Standard deviation scores for all outcome variables were used. Analyses are adjusted for age, sex and ethnicity.

† < 0.05 * P-value<0.01 ** P-value<0.001

Supplementary Table S6. Comparison of subject characteristics between children included and not included in the analyses

Participation
N = 6,523 / No participation
N = 1,782 / P value
Childhood Characteristics
Sex, No. (%) / 0.18
Boys / 3275 (50.2) / 917 (51.5)
Girls / 3248 (49.8) / 864 (48.5)
Ethnicity, No. (%) / 0.37
European / 4080 (62.5) / 1029 (57.7)
Non-European / 2277 (34.9) / 586 (32.9)
Gestational age at birth, median (95% range) / 40.1 (35.7, 42.3) / 39.9 (33.7, 42.3) / <0.001
Birth weight (g), mean (SD) / 3306 (643) / 3423 (555) / <0.001

Values are means (standard deviation), percentages or median (95% range). P-value was estimated by using One-Way ANOVA test and Chi-square tests.